Evaluation of Maternal Near-Miss Cases at a Tertiary Care Centre

Background: Maternal near-miss cases provide valuable information regarding deficits and strengths in the maternal health care system.The objectives of the current study were to describe the demographic and clinical profile of near-miss cases, assess the effectiveness of referrals, identify frequent causes, and review interventions and outcomes in a tertiary care center.Methods: All near-miss cases detected during the study period were considered and assessed based on the WHO clinical criteria.Clinical presentations, interventions, times of referral, demographic information, and outcomes were recorded.Laboratory criteria were recorded but not used extensively due to the lack of resources.Multidisciplinary team management was performed.Results: Most near-miss cases were rural, young women of low socioeconomic status, who were predominantly literate up to the primary level.The majority were primigravida, presenting between 28-36 weeks of gestation.The referral was better; the delay was reported in less than one-fourth of cases.Identification was primarily clinical, and laboratory identification was low.Invasive ventilatory support and inotropic support were the most frequent interventions.Hypertensive disorders, especially antepartum eclampsia, were the most common causes, followed by hemorrhagic complications.Other dangerous conditions were pulmonary edema, Guillain-Barr syndrome, meningitis, and hepatitis E. Preterm deliveries were common, but most cases had improved fetal outcomes. Conclusion:Proper management of near-miss cases in the ICU emphasizes the need for early detection, immediate referral, and well-coordinated multidisciplinary care.Supporting healthcare infrastructure and clinical education can also be used to further minimize maternal morbidity and mortality, as well as overall maternal health.